The Forgotten Complication of Recurrent Nephrolithiasis: “Squamous Cell Carcinoma of the Renal Pelvis”—A Case and Review of the Literature

Abstract

Squamous cell carcinoma (SCC) of the renal pelvis is an aggressive tumor with insidious onset of unspecific symptoms and advanced stages at diagnosis. It is a rare entity, accounting for 0.5–8% of renal tumors. In this paper, we describe the case of a patient with a history of recurrent nephrolithiasis that presented with an aggressive form of SCC of the renal pelvis with rapid relapse after resection.

A Case of Squamous Cell Carcinoma of Kidney Manifesting After Percutaneous Nephrolithotomy for Renal Pelvic Calculi

“…The presence of renal stones increases the risk of developing squamous cell carcinoma (SCC) of the renal pelvis 5 . SCC is a rare entity in the upper urinary tract with an incidence of 0.7 to 7% of all upper urinary tract cancers 3,6 . Various risk factors have been associated with renal pelvic SCC like nephrolithiasis, chronic pyelonephritis, renal tuberculosis, radiation therapy, percutaneous nephrostomy, immunosuppression, schistosomiasis, vitamin A deficiency, smoking, and several endogenous/exogenous chemicals etc 1,6 .…”

“…SCC is a rare entity in the upper urinary tract with an incidence of 0.7 to 7% of all upper urinary tract cancers 3,6 . Various risk factors have been associated with renal pelvic SCC like nephrolithiasis, chronic pyelonephritis, renal tuberculosis, radiation therapy, percutaneous nephrostomy, immunosuppression, schistosomiasis, vitamin A deficiency, smoking, and several endogenous/exogenous chemicals etc 1,6 . Chronic irritation due to long-standing nephrolithiasis, inflammation, and infection initiates squamous metaplasia of the renal collecting system, which may progress to dysplasia and carcinoma in some patients 7 .…”

“…Differential diagnoses for renal squamous cell carcinomas are urothelial carcinomas and xanthogranulomatous pyelonephritis. To make a correct diagnosis, an extensive histopathological examination should be made by pathologists to ensure squamous differentiation and exclude all other differentials 4,6,9,10 .…”